{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:41:27Z","timestamp":1747183287578,"version":"3.40.5"},"reference-count":35,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T00:00:00Z","timestamp":1714003200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patients with severe respiratory failure due to COVID\u201019 who are not under mechanical ventilation may develop severe hypoxemia when complicated with spontaneous pneumomediastinum (PM). These patients may be harmed by invasive ventilation. Alternatively, veno\u2010venous (V\u2010V) extracorporeal membrane oxygenation (ECMO) may be applied. We report on the efficacy of V\u2010V ECMO and invasive ventilation as initial advanced respiratory support in patients with COVID\u201019 and acute respiratory failure due to spontaneous PM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective cohort study performed between March 2020 and January 2022. Enrolled patients had COVID\u201019 and acute respiratory failure due to spontaneous PM and were not invasively ventilated. Patients were treated in the intensive care unit (ICU) with invasive ventilation (invasive ventilation group) or V\u2010V ECMO support (V\u2010V ECMO group) as the main therapeutic option. The primary outcomes were mortality and ICU discharge at 90\u2009days after ICU admission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010two patients were included in this study (invasive ventilation group: 13 [59%]; V\u2010V ECMO group: 9 [41%]). The V\u2010V ECMO strategy was significantly associated with lower mortality (hazard ratio [HR] 0.33 [95% CI 0.12\u20130.97], <jats:italic>p<\/jats:italic>\u2009=\u20090.04). Five (38%) patients in the V\u2010V ECMO group were intubated and eight (89%) patients in the invasive ventilation group required V\u2010V ECMO support within 30\u2009days from ICU admission. Three (33%) patients in the V\u2010V ECMO group were discharged from ICU within 90\u2009days compared to one (8%) patient in the invasive ventilation group (HR 4.71 [95% CI 0.48\u201345.3], <jats:italic>p<\/jats:italic>\u2009=\u20090.18).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Preliminary data suggest that V\u2010V ECMO without invasive ventilation may improve survival in COVID\u201019\u2010related acute respiratory failure due to spontaneous PM. The study's retrospective design and limited sample size underscore the necessity for additional investigation and warrant caution.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aor.14760","type":"journal-article","created":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T08:33:35Z","timestamp":1714034015000},"page":"1038-1048","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Extracorporeal membrane oxygenation versus invasive ventilation in patients with <scp>COVID<\/scp>\u201019 acute respiratory distress syndrome and pneumomediastinum: A cohort trial"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0156-3628","authenticated-orcid":false,"given":"Rachid","family":"Attou","sequence":"first","affiliation":[{"name":"Department of Intensive Care Brugmann University Hospital, Universit\u00e9 Libre de Bruxelles  Brussels Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9187-7574","authenticated-orcid":false,"given":"Sebastien","family":"Redant","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Brugmann University Hospital, Universit\u00e9 Libre de Bruxelles  Brussels Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4048-740X","authenticated-orcid":false,"given":"Dimitrios","family":"Velissaris","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University Hospital of Patras  Patras Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5074-7132","authenticated-orcid":false,"given":"Keitiane","family":"Kefer","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Brugmann University Hospital, Universit\u00e9 Libre de Bruxelles  Brussels Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mazen","family":"Abou\u00a0Lebdeh","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Brugmann University Hospital, Universit\u00e9 Libre de Bruxelles  Brussels Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Waterplas","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Brugmann University Hospital, Universit\u00e9 Libre de Bruxelles  Brussels Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2920-8350","authenticated-orcid":false,"given":"Charalampos","family":"Pierrakos","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Brugmann University Hospital, Universit\u00e9 Libre de Bruxelles  Brussels 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